Conference Resources | Abstracts
September 3
rd
– 6
th
, 2014 | Toronto, Canada |
246
P158
Be aware of the importance of good metabolic control in pediatric diabetes care
J. Anderzén
1
, U. Samuelsson
2
, L. Hanberger
2
, K. Åkesson
1,3
1
Ryhov County Hospital, Department of Pediatrics, Jönköping, Sweden,
2
Linköping University,
Department of Pediatrics and Department of Clinical and Experimental Medicine, Linköping, Sweden,
3
Futurum - Academy for Health and Care, Jönköping, Sweden
Objectives:
To compare the impact of good (HbA1c< 57mmol/mol IFCC/7.4% NGSP) and poor
metabolic control (HbA1c >78 mmol/mol IFCC/9.3% NGSP) during adolescence with HbA1c and
cardiovascular complications in young adults.
Methods:
Data on 4239 persons with type 1 diabetes registered in the Swedish Pediatric National
Quality registry (Swediabkids) 13-18 years of age and later in the National Diabetes Registry (NDR)
year 2011 and 2012 was used. Mean HbA1c, smoking and microvascular complications were studied
in the groups shown in the table. These groups were chosen to highlight possible differences.
Results:
Micro- and macroalbuminuria was significantly more frequent (P< 0.01) in the patient group
that had mean HbA1c > 78 mmol/mol in both registries compared to the patients with HbA1c < 57
mmol/mol. The age distribution showed that the largest proportion of patients (93.5% n=3975) was
below 30 years of age, and yet over 80% of those with HbA1c > 78 mmol/mol in Swediabkids already
had retinopathy. There were significantly (P< 0.001) more smokers in the group with HbA1c >78
mmol/mol.
Mean HbA1c in
SWE-NDR
mmol/mol
Microalbuminuria
%
(n=affected/total)
Macroalbuminuria
%
(n=affected/total)
Retinopathy %
(n=affected/total)
Smoking %
(n=smokers/total)
<57-<57
3.8 (12/315)
1.7 (5/297)
26.6 (85/319)
9.1 (33/360)
<57->78
9.1 (5/55)
0 (0/53)
32.8 (21/64)
13.6 (10/74)
>78-<57
10.3 (6/58)
3.3 (2/60)
86.2 (50/58)
17.7 (12/68)
>78->78
17.9 (44/246)
6.7 (16/239)
81.6 (235/288)
39.1 (136/322)
[Table 1]
Conclusions:
It is important that the pediatric diabetes teams are aware of the impact of a good
metabolic control during adolescence to reduce the risk of microvascular complications in young
adults. Smoking must be reduced as those with the highest HbA1c also more frequently were smokers
which further increases the risk of complications.
